| NPI | 1558595306 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2015-00584) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT195099) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT195099) | |
| 207L00000X Anesthesiology (Licence: PA MD447609) | |
| Enumeration Date | 2009-05-08 |
| Last Update Date | 2016-12-14 |